甲型肝炎减毒活疫苗再免疫的研究.docVIP

甲型肝炎减毒活疫苗再免疫的研究刘翌1　徐志一1　欧阳佩英1　赵守军1　吴婉贞2 　　【摘要】　目的　对甲型肝炎减毒活疫苗加强免疫的可能性进行研究。方法　分别设置再免疫组、初免疫组和自然感染组。用Abbott EIA改良法定性和定量检测血清中的甲型肝炎抗体。　结果 再免疫后甲型肝炎抗体阳性率和几何平均滴度在2周内升高，与初免疫组抗体阳性率和几何平均滴度缓慢上升至3个月以后达到高峰形成对比。再免疫组和自然感染组对活疫苗免疫反应存在区别，这在研究疫苗免疫持久性时应予考虑。再免疫组初免成功抗体又转阴者，再免疫后抗体阳性率83.3%(10/12)，显著高于初免疫失败者再免疫后的阳性率50%(17/34)，两者又均高于初免疫者(29.6%)。结论　再免疫可引起免疫回忆反应，且初免疫成功率直接影响到再免疫的效果。Abbott EIA改良法检测血清中甲型肝炎抗体仍低估了原发性免疫反应，需用更为灵敏特异的方法检测疫苗抗体。 　　【关键词】　病毒性肝炎疫苗　　肝炎，甲型　　接种 Studies on Re-immunization with Live Attenuated Hepatitis A Vaccine　　Liu Yi, Xu Zhiyi, Ouyang Pei-ying, et al. Department of Epidemiology, Shanghai Medical University, Shanghai 200032 　　【Abstract】　Objective　The possibility of re-immunization with a booster dose of live attenuated hepatitis A (HA) vaccine was studied. Methods　Children randomly sampled were divided into three groups with re-immunization, primary immunization and immunity via natural infection. Antibodies against heaptitis A virus (anti-HAV) were detected qualitatively and quantitatively with modified Abbott enzyme immunoassay (EIA). Results　Proportion of children with positive anti-HAV and its mean geometric titer (GMT) increased within two weeks after re-immunization, and as compared, those increased slowly and GMT reached the peak three months after primary immunization. Response to the live attenuated vaccine differed between the groups of re-immunization and immunity via natural infection, and should be taken into consideration in studying immune persistence of the vaccine. Proportion of children, who converted negative of their anti-HAV after primary immunization, with positive anti-HAV after re-immunization was 83.3% (10/12), significantly higher than that in those who failed in primary immunization and then were vaccinated again (50%, with 17/34), and that in both of them were higher than in primary immunization (29.6%). Conclusion　Reminiscence could be induced by re-immunization, and the effects of it depended on primary immunization. Detection of anti-HAV with